PROJECT 2 Cognition in the Informatics for Diabetes Education and Telemedicine (IDEATel) Study Project Leader: Jose Luchsinger, MD Co-Investigators: Jennifer Manly, PhD Lawrence Honig, MD Richard Mayeux, MD, MSc Abstract Cognitive impairment and Alzheimer's disease (AD) are some of the most pressing public health problems of our generation. There is no known prevention or cure for AD. Work by the applicant has demonstrated that Type 2 diabetes and hyperinsulinemia are the most important risk factors for cognitive impairment and AD in Northern New York City, but it is not known what factors affect the risk of cognitive impairment and AD among persons with type 2 diabetes, including diabetes treatment. In this project the applicant proposes to examine the association of markers of insulin resistance (insulin, adiponectin), and inflammation (C-reactive protein) with memory impairment and an AD biomarker in an ongoing ancillary study of cognition among persons with diabetes (IDEATel- Cognition). The proposed biomarkers are not currently part of IDEATel-Cognition. The study has already enrolled 491 persons and plans to follow them for 2 yearly intervals after baseline. Data collected in this study will help identify factors that could be modified to alter the risk of cognitive impairment and AD among persons with diabetes. The ultimate goal of this proposal is to collect data that will serve as preliminary data for interventional and translational studies of diabetes and cognitive impairment. This proposal would fund the new biomarkers, and allow the applicant to significantly expand his effort until completion of the study and during the application process for related projects.